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A hands on or hands off approach to patients?

BMJ 1999; 318 doi: (Published 15 May 1999) Cite this as: BMJ 1999;318:1361
  1. N E Dudley, consultant surgeon
  1. Oxford

Oxford medical students starting their clinical course may be amused to contemplate the scene nearly 40 years ago when the three senior general surgeons on the staff at the John Radcliffe Hospital were assigned to their first medical and surgical firms at St Bartholomew's Hospital.

In those days students attached to surgical firms were known as dressers because part of their duties involved changing the dressings of the patients assigned to their care. Strict protocols laid down by the nursing hierarchy enshrined strict “no touch” techniques founded on scrupulous asepsis. So right from the first days on the wards, medics learnt important lessons by the bedsides of their own patients.

The dressers also served for a short time as nursing auxiliaries. A major collective responsibility of the firm students was the phlebotomy service. All biochemistry request cards written out by the house staff were shared out among the available students.

Students realised quickly that they were …

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